Baby Z Is In the Hospital

I didn't think he was that sick.

The week before last, 6 of the 8 babies in the infants' room at day care were home sick. He was one of the two who remained healthy. As far as I know, none of them had to be admitted to the hospital.

We thought that we had somehow avoided the inevitable - that we got lucky or that he had a strong immune system for a 4-month-old or a combination of both.

On Thursday, he developed a fever of 101.5 at the end of the day at day care. On Friday, Tylenol was controlling his fever (we only gave it when he reached 101 or higher), he was nursing well, and he was his normal happy, smiley self.

That night, he started to become fussy. He didn't want his last nursing session, and we could hear the cough with a bit of wetness start to develop. We had him sleep in his bouncy seat since that put him at an incline. He woke up and fussed several times, but we were always able to get him back to sleep, and he even nursed at 2:30 a.m.

Since he had a rough night, I called the pediatrician's office when they opened on Saturday morning and asked for a same-day sick appointment. (We're lucky that our Pedi's office is open half days on Saturdays and Sundays.)

The pediatrician told us pretty much what I expected - 'tis the season, crud is going around, keep him hydrated (using Pedialyte if necessary), use a humidifier (we already were), and suction his nose if needed (it wasn't). He checked his oxygen saturation level, saw that it was a bit low (in the low 90s) but said it was because the machine couldn't get a good reading with all the kicking Z was doing.

We went home, and he ate well at his next feeding. But then the feeding after that, he wouldn't eat, he was being fussy and we couldn't get him settled, and his fever, which had risen to 103.4, had only come down to 102.6 an hour after the most recent dose of Tylenol.

We decided I would take him to the ER, just to be safe. I figured they would look at me, say, "Lady, crud is going around. Keep him hydrated, use a humidifier, go home." We decided R would not come with us, since there were Christmas gifts to wrap and chores to do and he himself was still recovering from the flu, despite all of us having gotten flu shots in the beginning of October.

Despite the crud going around, we were the only ones in the pediatrics ER waiting room. We were taken into triage quickly. His temperature was 102.8, and his oxygen sat was in the low 80s. The triage nurse dialed the nurse's station. Then she ordered, "Grab your bags, let's move!"

Suddenly, we were in a scene from ER. There were 2 people already in the room when the 3 of us got there, and the doctor and one more person came rushing in. They were grabbing things off the walls, the doctor was rapid-fire ordering procedures, tests, and treatments, someone grabbed an oxygen mask and put it on Z while another person started working on an IV.

I stood against the wall, dazed, confused, watching my not-even-5-month-old become part of a medical drama.

I stepped out to call R. "Um, I think you need to come down here, now." The ER doc heard me and called out, "He's (meaning the baby) going to be staying." When I hung up with R and stepped back into the room, the doc looked at me and said, "Ma'am, your baby is SICK."

He wasn't meaning it as an indictment, he was just trying to get me to understand the gravity of the situation. I was still stunned. Z hadn't been screaming uncontrollably. He had been fussy, but he didn't seem particularly weak or limp. In fact, he fell asleep on the drive to the ER and did not make a single peep the whole time we were checking in, except for one tiny cough that even a totally healthy baby might have made. Because of his total calmness through that process, I had almost decided to turn around and go home.

It's a good thing I didn't.

He has pneumonia.

And RSV.

And enterovirus.

I feel so guilty. How could I have not known he was so sick?

People keep saying, "You must be so scared..." They're referring to him being in the hospital. But I'm not actually scared about that. He's on oxygen, he's getting IV fluids, he's getting respiratory services, so I feel that he's getting the care he needs to make a full recovery. And given our medical histories in the past decade, the medical setting doesn't intimidate us or even faze us.

What scares me is that I didn't know he was so sick.

That I almost made a bad call by almost turning around and leaving.

That I could have been trying to take care of a baby at home with pneumonia and two viruses and not even know it.

Yes, I realize he would have continued to get sicker and we would have realized at some point that it was truly necessary to take him to the ER, rather than just take him out of an abundance of caution. But what if we would have realized too late? There but for the grace of God go I.

Thankfully, after 2 more rough nights, he seems to have turned a corner.

He was able to come off the oxygen for a few hours this afternoon before having to go back on it, and the treatments the respiratory services team are doing are helping him to breathe easier today, which translates into him being able to rest more and both of us getting more sleep. The pediatrician doing rounds today said we may be able to be home in time for Christmas, but no guarantees yet.

I'm just glad I decided to err on the side of being overly cautious.

Joyous Sounds

I am sitting here on the couch, working on making photo gifts for Christmas, while R is changing Mr. Z's diaper on the changing table right behind me. He is making silly faces at Mr. Z, who is giggling and laughing and giggling some more.

His giggles are making me giggle.

How is it that this is my life now? I ask myself that question every morning and every night. It still all feels like a dream.

More pictures

I have a dozen posts in my head - about learning to juggle caring for two kiddos, about how incredibly full my arms and heart feel when I'm holding both of them at the same time, about the mommy guilt that came with circumcision, about how we're finding our rhythm, about how I'm working toward making a major change and keep debating whether to stick with the plan (which involves staying the course for the next 2.5 years) or seizing the moment and just going for it now (or, at least, in the next 6 months).

None of those have made it out of my head and onto a screen yet. But, we did get the digital images this week from the photo session we did when Z was 2 weeks old, so I thought I'd share a couple. It's hard to believe he will already be 2 months next week!

Such a sweet smile.

One of my favorite photos ever. Pure joy. So thankful.

Pictures

I was going to write another post but then realized I hadn't put up the pictures I had promised. The days fly by in a blur! Life with a toddler and a newborn is even more chaotic than I had expected. Chaotic, but wonderful.

Without further ado, photos of Mr. Z:

In his going-home outfit.

I love how his eyes are open for this one. Interestingly, Miss A's eyes were open for this pose, too. For both of them, it was the only pose in their entire photo shoots where they didn't have their eyes closed. I wonder if it's something about the pose that makes them open?

His sister is a blondie (like their dad), but he has a full head of dark hair, like his momma.

He's Here!

R and I are thrilled to announce that Za.cha.ry arrived as scheduled this morning via a C-section that went very well. So far, his temperament is proving to be very much like his dad's - he is mellow, quiet, and rarely makes a fuss.

Mr. Z had been measuring in the 80th percentile range for abdominal girth, so I was a bit concerned that the gestational diabetes was making him pack on more weight than usual even though my numbers have been fairly easily controlled. He wound up weighing in at less than Miss A did on this date (both were delivered at exactly 38w0d): 7 lb. 7 oz. compared with her 7 lb. 12 oz.

Apgars were 9/9. However, his initial blood glucose level was described as "borderline" at 49. They want it to be at least 40. A repeat test was down to 46. When they tested for a third time, after our first nursing session, he was holding steady at 46, so they said there was no need to test again unless we wind up having difficulty feeding him. The second and third nursing sessions we did went well, so hopefully re-testing won't be necessary.

I'm a bit more mellow and calm myself this time around. With Miss A, I didn't sleep at all that first night because I was worried that she might stop breathing (not because of a specific medical issue, just paranoia on my part). This time, caring for an infant in the hospital while R's parents watch our active toddler feels like a vacation, and I plan to try to get some sleep tonight. I do still check frequently to make sure he's breathing, because he's so much quieter than I remember Miss A being, but I don't feel quite so terrified about it.

We're still in a state of disbelief that we now have two children. Two!, when for so long it seemed like having even one was a pipe dream.

Pictures to come, probably in the next few days...

Counting Down the Hours with Mixed Feelings

Kiddo is still incubating. We are down to the final hours - as I type this, his arrival should be about 49 hours away at the most. We are scheduled to be in the OR for another C-section at 9 a.m. PT on Saturday.

Last time, with Miss A, I was so excited about the idea we would hopefully finally have a baby that I wasn't really focused on anything else, and I couldn't wait for her to get here.

While I'm certainly eager to meet this little guy, this time around there are other feelings rising more to the surface. I know how high-strung I was during Miss A's pregnancy, but in reality, while there were certainly a lot of scary moments and uncertainty in the first trimester of both of these pregnancies, I have loved just about every moment of being pregnant.

I'm not sure that we will try for a third. If I was 10 years younger, the answer would be "probably", but since I'm not (I turned 40 a couple of weeks ago), we're at the "probably not" stage. Actually, R would tell you that we're at the "definitely not!" stage, but I haven't reached the point of absolute certainty about it yet.

And so, given those things, I am feeling a bit melancholy about this pregnancy coming to an end.

We're also reaching an end of an era in being a family of three. We have so much fun with Miss A, and she gets so much attention from both of us. In the evening, we both encourage her in eating her dinner, we both help her brush her teeth and give her a bath.

Now we will have to divide and conquer. I know it will be an adjustment for her to not have the full attention of both of us. It will be an adjustment for us, too. But I know we'll all figure it out.

I'm also a bit nervous about this kiddo being a boy. That's ironic, because when we were expecting Miss A, my mindset was all about a boy, and finding out that she was a girl threw me for a loop. But now I'm used to having a girl, and a very girly-girl one at that, which is something I am definitely not.

Even at 2 years and 4 months, even with most of her toys being things like blocks, Legos, and toys with gears, with very few pink toys and only one doll (which it didn't even occur to me to buy for her until she was nearly 2), and a playroom that has very little pink in it, she loves pink, tea parties, fancy dresses, and pretty shoes. She has even recently insisted on wearing her Christmas dress (with its crushed velvet top and poufy taffeta skirt) to day care and to my birthday dinner. The day care teachers said she absolutely loved wearing her dress and insisted on keeping it on all day rather than changing into the other clothes we had sent with her, even though it is 110 degrees where we live.

So I have learned to embrace the girly-ness, and I even enjoy tea parties now.

But it will also be good for there to be a bit more testosterone in our world. Aside from one male dog in our household, R is surrounded by females - my mom, me, Miss A, one female dog, and two female cats. It's amazing that the guy is still sane... :-)

My next post will hopefully be a birth announcement. Stay tuned!

The Countdown Begins

It's still kind of hard to believe, but we are less than 4 weeks away from delivery. If Kiddo does not arrive on his own before then, he is scheduled to arrive on July 26. That is 38w0d, which is exactly the point at which Miss A arrived, of her own choosing.

With Miss A, I was sure we would have to go all the way to our scheduled day, which was 38w4d. She surprised us by coming 4 days early. With this Kiddo, I have a feeling he may be earlier than 38w0d. But then again, based on our history, that will probably mean he goes all the way to the 26th.

At the NST on Friday, I was having contractions. They were very mild, but I could feel them, and there were more of them than what I had with Miss A at that point in her pregnancy (1 contraction during the NST that I could not even feel). I've had more contractions here and there since then that I can definitely feel, but nothing on a regular basis. So that's part of what's making me think he may arrive early.

Also, he started to move down a couple of weeks ago and has pretty much stayed there. That's making me have to visit the restroom frequently, but I can certainly live with that. I really can't complain much about pregnancy at all - amazingly, my swelling (I'm 34w3d) is practically non-existent, which is even less than I had with Miss A.

The biggest challenge I'm having at the moment is that we live someplace where it gets ridiculously hot during the summers. I'm used to it, and it usually doesn't bother me at all, but being pregnant, the heat makes me light-headed and gives me tunnel vision if I'm not careful. So I'm trying to stay under ceiling fans all the time and avoid going outside during the warmest part of the day. At Miss A's annual cardiology appointment yesterday (it went fine), it started to get warm inside the exam room, and I had to go stand in the hallway where it was cooler for a little while. Hopefully my body will revert back to being able to handle the heat after delivery.

I am definitely a bit more relaxed - or maybe just too busy to be as obsessively stressed - this time around, but I still have my moments of nervousness. And I still repeat in my head the same silent prayer/request I constantly used with Miss A: Please, dear God, let this end well.

Whew, what a month!

It was the Wednesday before Mother's Day when Miss A had the accident that led to one of her teeth having to be pulled, which I wrote about in my last post. The poor thing hasn't been able to catch much of a break since then, although I'm hoping that now (please don't let this jinx it) we'll have a quiet period for a while.

She went back to day care that following Monday. That Wednesday night, a week after her accident, she developed a fever. We wound up in the ER with her on Friday night because her fever spiked and she was still screaming and crying an hour after it came back down with the help of medicine. She was finally able to go back to day care on Tuesday.

After three days of normalcy, that Friday (the start of Memorial Day weekend) she came home from day care with a stomach bug that was going around.

The stomach bug led to another problem we've not had to deal with before: constipation.

We kept pushing water, which she drinks pretty happily. We tried the Pedia-lax liquid suppositories, 2 nights in a row. They made her cramp up and scream for an hour, but nothing else. We tried to offer her "soda" - prune juice mixed with water so that it had bubbles in it and looked like R's Coke. We offered apple juice, too.

Did I mention that we apparently have the only child in the world who does not like juice or soda?

Finally, on our third trip back to the pediatrician in a week, he suggested we give her Miralax. That took 2 days, but it finally worked. It was around this time that I also came down with bronchitis and a sinus infection and had to spend as much time as possible in bed for about a week, because I was too weak to sit up for more than 30 minutes or so at a time.

So the week of Memorial Day, she was home all week until that Friday. When R went to pick her up that Friday afternoon, the lead teacher alerted him that she thought Miss A might have a urinary tract infection based on complaining about pain as soon as her diaper got wet and suddenly refusing to sit on the potty. (She had loved to do that up until this point.)

Back to the pediatrician we went.

Do you know how difficult it is to get a urine sample out of a barely-2-year-old? Seriously, I think it is the most frustrating thing I have experienced in my brief 2 years as a parent. After 6 days of dealing with that, I was in tears, too.

She would not sit on the potty. She would not sit with her naked bottom on my bare, cross-legged lap (the specimen cup tucked underneath her). Bribing with cupcakes did not help. Having her take off her diaper and stand there in the bathroom, in hopes she would just eventually go and we could shove the cup against her legs and catch anything we possibly could did not pan out.

Zip, zilch, nada - it's amazing how much bladder control a toddler can have when it's the exact opposite of what you want them to have.

Back to the pediatrician we went. We were going to have to resort to having him get a sample via a catheter, which was an experience I was hoping to spare her. It did not go well. He was not able to get a sample.

After another 4 days of her complaining and crying any time her diaper was the slightest bit wet, we wound up going the route of a plastic specimen bag that adheres to the appropriate area via a semi-sticky piece of foam and catches the urine in the attached bag. The reason the pediatrician didn't take that approach to begin with is because it's not a sterile approach (I read online that up to 75% of samples can be contaminated), so kiddos oftentimes wind up having to be treated when it's really a false negative.

Yea - finally success! Or so I figured, because there was a blue line on her diaper. I thought since that was the case, she must have filled the bag with enough that it overflowed into the diaper.

Ha! Silly, optimistic me.

There were literally all of about 3 drops of pee in the bag itself. The diaper was definitely wet, and the bag was still adhered to where we put it, so clearly there was something we didn't do right. I didn't have much hope for the lab being able to get enough of a sample off of that, which was the point at which I wanted to just break down and cry. But we went ahead and took it in anyway.

Imagine my surprise when the doctor called a few days later to say they tested it and she didn't have a UTI. So, yea for that!

Thankfully, she seems to be making progress. She's not complaining about wet diapers anymore and even asked to sit on the potty twice tonight, and stayed there (her naked little bottom on the seat, rather than in a diaper and sitting on the lid) for 2-3 minutes each time.

She's weaning off the Miralax, and so far her BMs are still normal. But the stomach bug really did a number on her GI system, because she's still consistently passing a fair amount of loud, stinky gas, which she never did regularly before this. Hopefully that will continue to improve with time, too.

And we're seeing progress on her mouth - last week, she finally started to drink out of a straw again, and this weekend, she began experimenting again with using her remaining front tooth to tear a piece off a slice of bread. Next week, she'll have an impression taken in order to get a fake tooth made. We don't want her to have to live with the gap for the next 5 years.

Here's hoping the next several weeks will be more calm than these last several have been!

Ouch! Miss A Has Another Accident

When I was pregnant with Miss A, a male co-worker told me how his only goal when his daughter was born a year or so prior was to keep her alive. I laughed and commented that I hoped to aim a little bit higher than just "alive".

Now I'm beginning to understand the wisdom of his words.

Miss A is just shy of 26 months, and already she has had a broken wrist and now has had to have one of her top front teeth pulled. If she continues to have injuries at this pace, we are in for a heck of a time!

This latest mishap occurred last Wednesday afternoon, at day care. Apparently, she was running around and collided with another little kiddo. In the process of trying to recover from that, she tripped, fell, and slammed (and I do mean slammed) into one of the little tables they sit at to eat.

I arrived to pick her up just a couple minutes after it occurred. There is nothing that prepares you for having your child open his or her mouth and seeing blood-covered teeth pointing in directions that teeth should not be pointing in.

She must have hit the edge of the table at an angle, because one of her top front teeth remained all the way down, but the bottom of it was pushed back toward the back of her mouth to the degree that it popped out of its socket and could not be re-positioned and salvaged. The dentist said it risked becoming infected within a couple of days and that an infection would damage the adult teeth that are just starting to solidify from a gelatinous texture right above it, so we agreed that the best course of action was to remove it.

The tooth to the outside of that one seems to have been shoved back up into the gums a little bit. He said the nerve may die and the tooth may discolor, but he thinks she'll be able to keep it. The other front tooth should also survive the incident, but it will take a while to look normal again - it was pushed a fair ways up into the gums, and the bottom of it is pointing out a bit now, so that tooth seemed to move in the opposite direction of the other one.

Miss A's poor little face is also horribly bruised, mostly on the right side. (It was the right front tooth that had to come out.) She has a dark blue/gray line of bruising that runs literally from the corner of her eye where it meets her nose, down to the corner of her mouth. Then there's more bruising to the side of her mouth and on her chin. She's very fair-skinned, so the bruises show up even more than they would on someone with less pale skin. She literally looks like she's been beaten up. When we go out in public, I feel like having her wear a sign that says "My parents don't beat me, really they don't..."

The bruising was more than the dentist expected, so he had us take her to the pediatrician to confirm that she did not have any facial fractures. Thankfully, she didn't.

I have to hand it to Miss A, though - she is quite the trooper. She had a couple doses of Advil the night it happened and the next day, but other than that, she has not asked for any pain meds. She's had to adjust the way she eats and drinks, but she's figured out how to put food on her molars in the back of her mouth so that she can still chew them up. Fortunately we had started to transition her to drinking out of an open cup without a lid about a month before this happened. She is able to do that quite well with very little spilling, which is helpful since sucking on a straw is probably going to continue being too painful for at least another week or two.

In a few weeks, we'll go back to the dentist so that she can get an impression made for a cosmetic fix. I don't know exactly what it involves yet or how it works, but we'll find out more details then. The dentist said it would be okay to leave the gap where that tooth was until her adult tooth comes in 5-6 years from now, but I don't want to do that to her. Right now her 2-year-old friends don't know enough to tease her about it, but I could see that changing as she gets a little bit older.

Boys are supposed to be even more rambunctious than girls, so if this is what things are like with Miss A, I can't imagine what sorts of calamities we may have to deal with from Kiddo #2!

Speaking of, we had our most recent checkup today. I'm 27w3d, and Kiddo's estimated weight is 2.5 pounds. So trucking right along. Twice-a-week biophysical profiles/non-stress tests start at 32 weeks, and then things should move quickly from there.

We're in the neighborhood of about 10-11 weeks away from delivery if all goes smoothly. It still seems very far away, but I have a feeling it may pass quickly. Hard to believe!

Gestational Diabetes...Or Not?

Since I had gestational diabetes with Miss A, this time my doctor had me test during the 24th week.

I was hoping that maybe somehow this time it would be different. But not surprisingly, I failed again. Normally I'm a pretty good test-taker, but this is one that seems to have me beat.

Overall, my numbers were a bit better than they were with Miss A. Then again, I also tested 2 weeks earlier, and I realize that pregnant women's insulin resistance increases as pregnancy progresses, so who knows if my numbers still would have been better if I hadn't taken it earlier this time around.

I went straight for the 3-hour test, so that I wouldn't have to drink the stuff for the 1-hour, fail, and then drink it again for the 3-hour.

My fasting level was 97. In men and non-pregnant women, it's supposed to be 99 or less, but in pregnant women, they want to see it at 95 or less. So I was just slightly off. My 1-hour was the one that was most out of range - I think it was 214, and it's supposed to be 180-something. Then the 2-hour level is supposed to be 155 or less, and I was at 177. I don't know what the 3-hour level is supposed to be, but whatever it is, mine was in the normal range at 86.

I met with the nurse practitioner at my doctor's office on Friday afternoon to review what I need to do to test at home. I decided to eat the way I normally do this weekend so that I could see just how far off my numbers are when I'm eating like I typically do, rather than guzzling the equivalent of 2.5 cans of Coke in 5 minutes.

So far, it turns out that when I'm eating like I normally do, my levels are just fine.

My fasting has been at 91 both days, and most of the tests I've done 1 hour after the start of eating have been below the 2-hour limit. (The glucose level is supposed to be 140 or less after 1 hour and 120 or less after 2 hours. Most of mine have been less than 120 after just 1 hour.)

As I said, I know insulin resistance increases throughout pregnancy, so I will continue to monitor for the duration. With Little Miss, minor tweaks in my diet - making sure I was including an adequate amount of protein at each meal, mostly - was all that was necessary to keep my levels within range. Hopefully that will continue to hold true this time around.

Other than that, we're continuing to do great, aside from me being annoyed by the fact that I'm now (as of yesterday) 25 weeks and still don't look very big.

When I went to the lab to take the test, I was wearing my regular jeans and a regular shirt. The tech who was checking people in looked at me and said "You're pregnant??" even though it was all over my lab orders. (I also had lab orders for a couple of other things at the same time, and all of them referenced my pregnant state.)

And then my mom felt compelled to share this little gem the other morning. It's her version of a compliment: "You're doing really well. If someone didn't know you were pregnant, they'd just think you were fat, not pregnant." R choked on his smoothie.

I'm still trying to figure out how looking fat is better than looking pregnant...

Viability

Yesterday was 24 weeks, which is technically the edge of viability.

From what I've read, Kiddo has a 50/50 chance of survival at this point, and every day during the 24th-25th weeks increases those odds by 3-4% per day, then 2-3% per day during the 26th and 27th weeks.

In my usual fashion of not counting my kiddos before they hatch, I am still holding my breath a bit and cheering for every extra added chance of survival that each day brings. But overall, I'm more calm this time around, as evidenced in part by my lack of constant "dear God, please let this end well" posts.

We had the fetal echocardiogram last week to get a better look at Kiddo's heart, since Miss A was born with a couple of cardiac issues and R has Brugada Syndrome. Everything looked as expected, so barring the perinatologist's ultrasound tech suddenly seeing something obvious and unexpected between now and birth, we don't have to visit the cardiologist for this Kiddo again until 2 weeks after birth. At that point, they will do an EKG to see if any abnormal rhythm pattern indicative of Brugada's is appearing. My guess is that it won't, and that will be just the first of many EKGs to come for Kiddo, as it has been for Miss A. She gets her next EKG in a few weeks.

Next up - This week will be the gestational diabetes test. Since I had it with Miss A, I asked to just do the 3-hour version of the test and save myself the trouble of having to chug down the stuff you have to drink for it twice.

I hope all of you are having a lovely spring!

Happy 2nd birthday, Miss A!

Two years ago today, this amazing little girl entered our lives, and our world will never be the same.

Happy birthday, Miss A!

Anatomy Scan

We had the Kiddo's anatomy scan recently. Overall, everything looked good.

There is a 4-chamber heart, 3 vessels in the cord, 2 kidneys, and the brain looked good. The only thing that was kind of unusual was the ultrasound tech couldn't get a clear picture of the stomach.

She is the opposite of an alarmist - in all of our scans with Miss A and up until this point with Kiddo, she had never given even the tiniest, slightest hint of any concern. So I started to get nervous when she kept fixating on it. But then the peri looked and felt like she saw it clearly, and while she was looking, the ultrasound tech left the room to go look at the images from our past ultrasounds. She came back and reported that she found very clear images of the stomach on a couple of recent ultrasounds, so then she was satisfied, and I breathed a little easier.

Since Miss A was born with pulmonary valve stenosis, we'll have a fetal echocardiogram to get a closer look at this Kiddo's heart in mid-April. After that, the gestational diabetes test is planned for the end of April, at 24 weeks. The peri is ordering it a little early since I had it with Miss A.

Once we have the GD results back, we'll pick a day to schedule the C-section. The peri and I have not had an in-depth conversation about this, but I did bring it up at a high level a few appointments ago.

I talked about my concern that my water breaking with Miss A was actually likely a minor placental abruption, and my concern about being at even higher risk for it this time because of that history and because of the large SCH in the first trimester. Because GD, high blood pressure (which was actually very good at the last appointment - 111/64), and advanced maternal age can also all cause the placenta to start breaking down early, she was receptive to my concerns.

She wants the GD results before we pick a date because she wants to know if that is going to be an additional risk factor, but she actually seemed open to delivering during the 37th week. She prefers her singleton patients to wait until 39 weeks, and in an ideal world, I'd be all for that. But given that Miss A came at 38w0d on her own and the risk factors that I have, 39 weeks feels a bit unlikely to both of us.

I'm all for going as far into the 37th week as possible, but I really don't want to push it beyond 38 weeks. Call it mommy instincts, call it fear, but whatever it is, there is something inside me that feels like the 37th week is the safest option, and anything beyond 38 weeks feels risky.

But at this point, even 37 weeks feels like forever away. I'm 19w1d today. How is it that I'm not even at 20 weeks yet? It feels like I should be in the third trimester by now. Not that I'm impatient or anything...

So This Was My Friday...

The perinatologist's office must be updating the patient portal they recently implemented, because I received about a dozen - literally - e-mails from them today.

Most of them were appointment reminders, with a few appointment cancellations thrown in for good measure, all related to past appointments. Then came an e-mail titled "Important Health Information Message". It sounded, well, important...so I clicked on the link.

It told me that based on my most recent appointment on Tuesday, I have high blood pressure.

First of all - um, yeah, no surprise there, I've been on medication for that for more than a year. Second of all - thank you for taking the wind out of my "yea, my blood pressure is doing well!" sails. I was actually quite pleased about my reading on Tuesday (122/64), particularly given that I had forgotten to take my medication that morning and because it was my first ever peri appointment without R there. (He was at home with Miss A, who somehow came down with scarlet fever on Sunday night. She is doing much better now and is mostly recovered.)

About 15 minutes later came another "Important Health Information Message" e-mail. Having not learned my lesson from the first one, I clicked again.

It told me I was fat.

Well, not in those words exactly, but something about a BMI above 30 and obesity, and well, you get the picture.

"But, wait!" I wanted to tell it. "You don't understand! I was wearing tennis shoes. And jeans. And I had just eaten lunch. And drank a lot of water. So my number isn't really quite as dire as you're making it out to be."

Except that e-mail messages about your BMI don't really care about what shoes or clothes you're wearing, and what you just ate. In reality, I know I need to lose a good bit of weight. And as much as I wish they did, the shoes and clothes and even the late lunch don't add up to enough to move me down to below 30, into the overweight category instead.

A couple of hours later, a nurse from my PCP's office called. She was calling to follow up on whether I had gone for an ultrasound on my leg.

It's a long story which I won't bore you with, completely unrelated to the bulge on my other leg that I mentioned in my last post, and nothing I was worried about. I had tried to get the ultrasound a couple days ago, but when I got to the imaging center there was a mix-up and they wound up not being able to do it, and I hadn't gotten around to rescheduling yet.

The nurse asked if I could drop everything and go get the ultrasound this afternoon.

So I did, and as soon as the ultrasound tech put the wand on the spot, she said, "Oh, look at that - you have a lovely varicose vein!"

Normally, my age doesn't bother me much. But today, after that little pronouncement, I'm feeling a bit middle-aged for the first time.

Then when we got home tonight after picking Miss A up from day care, I opened the mail. I had asked R last month if we had paid the December IVIG bill, and he said yes. It turned out we had paid the November one but not the December one. We owe more than $4,200.

So now I'm feeling middle-aged and financially broke.

But Kiddo's heart was still beating strong and he was wiggling around on Tuesday. And Miss A is on the mend, spends her weekdays in a wonderful day care where all the teachers truly care about her and where she loves hanging out with her little friends, and she continues to amaze us every day.

So overall, even middle-aged and financially in a major hole, life is still very, very good.

It Wasn't Amniotic Fluid

Thank you all for your comments and concern. Kiddo is doing well - he was moving around when we checked on him on Monday, and the ultrasound tech said there was plenty of amniotic fluid.

Apparently it really was just sweat. It didn't happen again to anything nearly that degree, so I wasn't too worried by Monday. I'm probably going to have to get used to it happening though, because I'm not due until August, and I live in a place where we're going to have 100-degree-plus temperatures long before then.

I apologize for the silence. I've gotten into my head again and gotten freaked out about something, so I've been ruminating on that for the past several days. I won't go into great detail, because I'm sick of me being in what seems to be a perpetually worried state about something, so I can't imagine how tired you guys are of hearing about it. I had been doing pretty well with the health anxiety, but it seems to have returned in full force lately.

Suffice it to say that I have what is best described as a bulge above my knee. (I'm not calling it a lump, because I can't feel a distinct mass - it feels more like the muscle is enlarged.) I've shown it to the perinatologist, and my PCP has ordered an MRI, which I will be getting on Wednesday. Odds, of course, are that it's nothing serious. However, I Googled "lump on quadriceps" and "bulge on thigh", and that was a mistake, because very scary things came up. Hence, the ruminating.

This is Hard (And, Gender Revealed)

The roller coaster continues.

Things looked great at our most recent appointment on Thursday afternoon. This afternoon, I wound up having to page the doctor on call because I'm concerned I may be leaking amniotic fluid. The doctor is concerned enough that she is having me come back in on Monday morning.

First, our Thursday appointment - Kiddo looked good, and was moving around and active. It is amazing how arms and legs go from being little stubs to looking like they are one long bone to two bones with a connecting joint in between, all in just a few brief weeks. The growth is amazing.

Arms and legs weren't the only thing we were able to see. Kiddo cooperated with giving us good views this week, and I was brave, so we found out.

We (ok, I) told a couple of people, but overall, we're still holding off on telling most people in our offline world, including our parents. But all of you have been so great at holding my hand, and I trust you to keep the secret, so:

Kiddo is a boy!

We knew that we had either 8 or 9 male embryos left, and only 3 or 4 females. So it wasn't really a surprise, more of a confirmation of what we expected.

If you're sensing a lack of enthusiasm in my words, please know that it has nothing to do with Kiddo himself. It's just that every time I start to let myself relax a little, things get scary again. And we still have a really long way to go since today is only 15 weeks. I'm just tired. Tired of this being so hard.

I finished weaning from progesterone last weekend. My levels had been in the upper 20s. It was rechecked on Thursday, and I got the results yesterday - 19.7. The clinic prefers it to be 20 or above, but the nurse said 19.7 was close enough and that I was officially released from their care.

With Miss A, my numbers were slightly lower and the reproductive immunologist had me go back on the suppositories for a few weeks. I decided that since I was close to 20, I would not freak out about it but would just ask the RI for an order to recheck the level again at the beginning of next week.

I don't think that progesterone necessarily has anything to do with the potential issue that arose today. It's just one more thing, and I'm really ready to be done with "one more thing".

This afternoon, I laid down to take a nap, and I realized my jeans were wet. Not so wet that liquid could be wrung out of them, but definitely far more than damp. And it wasn't just one small spot, it was a couple inches down both of the inner thigh areas, too.

I've read that amniotic fluid has an ammonia-like smell. Whatever the fluid is, it didn't seem to smell like that, but it also didn't smell like urine.

I've also read that a subchorionic hematoma, especially a large one which is what mine was, can cause water to leak or break early. The doctor on call, who is the other doctor in the practice, confirmed that is true. She said that odds are it's not amniotic fluid leaking, but it could be.

She also said that I could go to the ER if I wanted, but that they would keep me in the ER and not send me to L&D since I'm not yet 20 weeks. She also mentioned that an ER ultrasound tech is unlikely to be able to tell us anything other than whether there's a heartbeat, because they are not as likely to be well versed in what a normal vs. abnormal level of amniotic fluid looks like. So I don't think we'll go to the ER unless I start to leak heavily or gush.

I know there are still a lot of reasons to be positive. This may not even be amniotic fluid at all.

I just want it to be July already, for Kiddo to be here, safe and healthy, in our arms.

'Believe in Good Things to Come'

An IRL friend who has been through IF and IVF sent me a text with that message today. Even after having Miss A and several encouraging ultrasounds with this pregnancy, sometimes I still need the reminder that this has the possibility of turning out well.

Today's ultrasound went well. Kiddo is continuing to grow on track. I decided to be brave and go ahead and find out the gender, since R wants to and he was so patient with waiting until 30 weeks with Miss A.

Kiddo did not cooperate in that plan, so we'll have to wait until next time.

Optimistic, Optimistic, and Just Plain Nervous

This post was going to be titled "Optimistic, Optimistic, and Nervously Optimistic." Apparently, the universe found that a bit too cocky.

We had another ultrasound and appointment yesterday. It went perfectly. And now, today, there is cramping and spotting. Mostly brown spotting, with maybe just a tiny bit of pink, but still. Spotting. And cramping with it. Sigh.

Yesterday was 11w6d. Kiddo's heartbeat was 160, and s/he measured exactly on track at 11w6d. We could see feet and hands at the ends of the legs and arms, could even mostly make out the individual fingers. The bones of the face were all very clear.

The nuchal fold measurements were all good, and the nasal bone was clearly present, making the chance of Down Syndrome pretty low, although since we had done CGH, we weren't particularly concerned about that anyway.

The ultrasound tech searched and searched, but she could not find a sign of the hematoma anywhere. Yea for that! She also announced that my placenta is mostly anterior, although it is not completely covering the right side, so she said to pay attention to the right side to feel movements when I get further along. (Apparently an anterior placenta makes it more difficult to feel movements.)

After the scan, we met with the peri. She said that with everything measuring right on track, looking good, and no sign of the hematoma, the risk of a loss at this point is low, and she is optimistic about this pregnancy. R is optimistic, too - he even wants to find out the gender as soon as we can this time around.

Realistically, I know I'm never going to be able to fully commit to boarding the "optimistic train" the way that they are, but I told R after our appointment that I am "nervously optimistic". For me, given our hisstory, I think that allowing myself to classify my outlook as "optimistic" this early on in the process, even if it is qualified with "nervously" in front of it, is still a huge leap ahead of where I was with Miss A's pregnancy.

Then this morning, Miss A and I had a playdate with a friend and her young son at an indoor jungle gym place. It's the first time we've been. I was on my feet a bit more than usual, keeping an eye on Miss A, since she was one of the littlest ones there. Toward the end of our visit, she wanted to go on some of the slides in the bigger kids area, so I had to slide with her. We were fine sliding multiple times on one of the open slides, but then I decided she might enjoy going down an enclosed slide. The only thing was, I had to hunch over a little, and as we went down, I felt a few stabbing pains.

I took it easy after that, and my friend took Miss A on the slides a few times so that I could sit down. We came home soon after, and everything seemed fine, so I didn't think anything more of it.

But then I went to the restroom and there was a tiny bit of brown spotting. And then the cramping started. It is mild and intermittent, but still, it is cramping, and you all know how I feel about that. And the amount of spotting seems to be increasing a little bit.

So now I am laying in bed, feeling every little twinge, and trying not to get up every 2 minutes to see if the spotting is increasing or turning to bright red.

I feel like there is no point in calling the peri, because all they are going to be able to tell me to do is what I am already doing - stay off my feet as much as possible and drink plenty of fluids. In the absence of bright red bleeding, I don't think there's any point in going to the ER, especially since we just had a scan yesterday.

So here we are, 12 weeks, and I'm back to just plain "nervous". It's going to be a very long 26-27 weeks if things continue like this...

Feeling Nervous

Apparently, 10 days is my limit between ultrasounds before I start to panic.

Nothing is super-obvious wrong, but I have been having some pelvic pains today that I don't totally like. The best way I can describe it is if I was in the 3rd or 4th week, I'd be thinking "Yea, maybe these are implantation pains!" and I'd be happy about them. But now, in the 11th week, I'm thinking, "Why am I feeling these pains now? What do they mean?" And I don't like that.

I called the peri's office. When I'm there in person, they always tell me I can come in early if I need extra reassurance, but when I call, the nurse usually finds a way to put me off unless there's a critical sign, like bright red bleeding, which thankfully there's not.

So the nurse told me to drink lots of water because she thinks I'm probably dehydrated and that's what's causing the pains, and call them back if bright red bleeding develops. Otherwise, they'll see me on Friday, which is still 84 or so hours away. Not that I'm counting or anything.

I tried the Doppler again over the weekend, but still no luck. I don't think that's necessarily a bad sign - I'm "fluffy" and I have a titled uterus, so I realize it may take a few more weeks (or longer) to start hearing it on there.

I want this to work. For the obvious reason, and also because I am really, really ready to be done with the infertility treatment phase of our lives.

Reprising my refrain from Miss A's pregnancy: Please, God, let this end well.

Double Digits

The most recent ultrasound was on Friday. Kiddo continues to measure 2 days ahead, the hematoma continues to remain the same size.

I was 9w6d on Friday, so assuming all is still well, we're officially in the double digits in terms of weeks.

Continuing with the trend of being more mellow this time around, I have not tried to break out the Doppler again. The ultrasound tech was able to do the ultrasound abdominally this last time, but barely, and their equipment is of course much more advanced than my $50 monitor.

It'll probably be at least a few more weeks before I'd be able to hear anything with it, other than the blood flow to my ovaries or uterus that I heard when I tried a few weeks ago. Since I hear the exact same thing on both sides and I know there's only one Kiddo in there, I know I'm not hearing fetal-related blood flow...

Since everything was looking stable, they gave me the option of having my next appointment in one week or two weeks. I opted to schedule for two weeks out. If it goes well, I may try to stick to that schedule, because with a toddler in the picture, it's just harder now to have weekly or more frequent appointments.

During Miss A's pregnancy, I think I only had one two-week interval between appointments and two 10-day intervals, and other than that, it was 1 or 2 appointments a week. So far I seem to be okay with it, but then again, it's only been 4 days. I may feel differently in another 4 days. :-)

And The Beat Goes On...

Somehow, amazingly, Kiddo still has a heartbeat.

It was 10 days between ultrasounds. I actually did pretty well with the wait - I'm a bit calmer with this pregnancy than I was with Miss A.

The heart rate was 183 bpm, which is great, and Kiddo is measuring 2 days ahead, at 9w1d. Out of all 8 pregnancies, there is only 1 other where we saw a heart beat as far along as 9 weeks, and that was the pregnancy with Miss A.

One wrinkle that came up is that I woke up yesterday really not feeling well. We saw the nurse practitioner after the ultrasound, and she thought I had the flu, so she prescribed Tamiflu. Miss A and R also started not feeling well, and today R got tested (the peri's office didn't have the rapid flu test), and he does indeed have the flu. So I'm pretty sure that's what Miss A and I have too. The nurse told R today that one of the main strains of flu going around wasn't included in this year's vaccine, so a lot of people are getting it even though they were vaccinated.

I have been working crazy hours since Tuesday, and I was supposed to work all weekend and all week next week, but the nurse practitioner said I need to rest, so she wrote a note for me to be off work "until further evaluation". She wants to see how I'm feeling and how things look during the next ultrasound next Friday.

It's pretty much the worst timing from a work perspective, but the baby's health has to come first. Thankfully, my boss is very understanding and supportive. My vice president is in town, and I have been working closely with him this week. I was supposed to meet with him on Monday.

I wasn't planning to inform him of the pregnancy unless I made it to 20 weeks, but my boss asked for permission to share my situation with him. She wants him to be clear that I'm not just flaking out of work for a minor cold, that the flu on top of a pregnancy with a serious complication becomes an even more serious situation.

Speaking of serious complication, the pesky hematoma is still there, and still unchanged in size. I was kind of surprised it wasn't smaller, because there continues to be blood every time I wipe. Now, every time I cough hard, there's a bit more bleeding. I just wish it would go away.

While I'm doing better (more calm) with this pregnancy, I'm still not close to being a "normal" patient. The peri's office doesn't even bother to try to schedule more than 1 appointment at a time for me - they just stick to scheduling the next appointment every time we're there. (Normally, if their patients are on a weekly or every-other-week schedule, they schedule about 4 weeks worth of appointments at a time.)

And I'm still refusing to look at the due date. It's listed on some of the ultrasound photos they give us, but I just hold my finger over that part of it. I know it's some time in August, because both of the ultrasound techs have forgotten after I've told them I don't want to know and started to say it. They said the month, but I managed to stop them before they got to the day. Given that Miss A's transfer was on July 13th and her EDD was March 30, since this Kiddo's transfer was on Nov. 21, I'm assuming the EDD is around the end of the first week of August, but I just don't want to know for sure yet.